By Chioma Obinna
Statistics have shown that, every two seconds, someone needs blood, particularly during festive periods. 34 per cent of pregnant women, according to reports, die in labour as a result of complications of bleeding and lack of blood for transfusion in Nigeria. Also in the country, arguably, circulatory collapse sequel to excessive blood loss is the biggest cause of deaths among injured patients in road traffic accidents. This is largely because bleeding can be external (revealed) or internal (concealed). And with Nigeria’s level of health care delivery, it is estimated that about 1.5 million units of blood are required per annum but far less is sourced.
Sunday Vanguard looks at the reasons Nigerians should donate blood without remuneration.
“You will never know how important donating blood is until you need it”, says Patrick Ogbonnaya, an accident victim. Ogbonnaya and his wife had bid their family goodbye and left their hometown in the eastern part of the country for Lagos. Minutes into the journey, the bus they had boarded for the trip started shaking. Like every other careful driver, the man behind the steering came down to check the tyres but was unable to uncover the problem. He went back into the bus and they continued the journey. About an hour later, tragedy struck. The bus summersaulted with many of the passengers of the bus critically injured and some dead.
The victims, including Patrick and his wife, were rushed to a nearby hospital. Sadly, although there were adequate medical personnel and equipment at the hospital, the blood bank was empty.
Having lost so much blood, doctors at the hospital needed blood transfusion to be carried out on Patrick, his wife and some of the accident victims while some others were to be wheeled into the theatre for quick life-saving surgeries.
However, efforts to get blood were futile. No blood could be found anywhere around. Although Patrick somehow survived, his wife and most of the victims died simply because blood was nowhere to be found.
They are among road accident victims who suffered massive blood loss but failed to get red blood cell transfusions of 50 pints or more.
Health watchers believe that many of the victims would have survived if the country had enough blood donors and if every Nigerian makes blood donation a part of his life. Today, the source of blood in most hospitals in Nigeria has remained the family replacement system. According to the World Health Organization, WHO, blood donation by one per cent of the population can meet a nation’s basic requirements for blood. Although, there is no sufficient data regarding the pints of blood generated in Nigeria, statistics available showed that the country needs about 1.5m pints per annum. Meanwhile, there are only five per cent voluntary donors and 60 per cent commercial donors as well as 30 per cent family replacement.
WHO says 57 countries are currently collecting 100 per cent of their blood supply from voluntary, unpaid blood donors with 112.5 million blood donations collected globally; and half of these are in high-income countries while countries like Nigeria lose thousands of lives every year due to shortage of blood in blood banks.
Experts say blood donation occurs when a person voluntarily has blood drawn and used for transfusions and/or made into biopharmaceutical medications by a process called fractionation. Donation may be of whole blood or of specific components directly.
Many Nigerians hardly donate blood voluntarily. For those who donate, they are forced to do it either because a family member needs it or for economic reasons. But experts say the safest blood donors are voluntary, non- remunerated blood donors from low-risk populations.
Studies have shown that blood from donors forced to do it or for economic reasons have been associated with significant higher prevalence of transfusion-transmissible infections (TTIs) including HIV, hepatitis B, hepatitis C, syphilis and Chagas disease.
WHO estimates that 5-10 per cent of HIV & AIDS infections in Africa occur from unsafe blood transfusions while 25 per cent of maternal deaths are attributed to a lack of blood for transfusion. Correspondingly, 15 per cent of child mortality in Africa may be due to the lack of adequate supply of safe blood for transfusion.
Also, statistics from WHO programme on blood transfusion safety, which accesses blood safety trends, safety and priorities, showed that less than one per cent of the population of developing countries donate blood compared with over 65 per cent in developed countries.
Apart from saving lives, studies have shown that people who voluntarily donate blood have the likelihood of living longer. Researchers found that the majority of the people who are regular blood donors rarely suffer from anaemia of the aged or the anaemia of the elderly.
Those who need blood
Findings showed that the average bone marrow transplant requires 120 units of platelets and approximately 20 units of red blood cells. Severe burn victims require approximately 20 units of plasma during their treatment and children being treated for cancer, premature infants and children having heart surgery need blood and platelets from donors of all types.
It has also been found that anaemic patients need blood transfusions to increase their iron levels whereas cancer, transplant and trauma patients, and patients undergoing open-heart surgery, require platelet transfusions to survive. Some patients with complications from severe sickle cell disease, an inherited disease that affects more than 80,000 people in the United States (98 per cent of whom are of African descent), receive blood transfusions every month – up to four units at a time.
However, expert say unless there is urgent change of perception among Nigerians regarding blood donation, these patients may not breathe the air of life due to acute shortage of blood donors,
According to the Head of Haematology Department, Lagos University Teaching Hospital (LUTH), Prof. Sulaimon Akanmu, donating blood voluntarily has been linked to longer life in those who do it regularly.
“The bone marrow of a regular donor is under constant challenge because, as he grows, his bone marrow tends to age. It ages from red marrow (capable of forming blood) to yellow marrow (incapable of forming blood). For people who are regular volunteer blood donors, their marrow age from red to yellow”, he told Sunday Vanguard.
Akanmu dismissed the notion that when people donate blood, they give out part of their bodies that is not replaceable and that they run short of blood and their lives at risk. He said the only true thing is that the cell of a regular blood donor does not age fast and he or she has the likelihood to live a longer life.
In a report, a Laboratory Blood Safety Programme Manager, Institute of Human Virology Nigeria, Mr. Abdullahi Abubakar, said blood donation lowers the risk of cancer.
Abubakar noted that the risk level of cancer drops depending on how often people donate blood.
Abubakar, who was quoting the Miller-Keystone Blood Centre, noted that consistent blood donation could help in lowering the risk of cancers of the liver, lung, colon, stomach and throat.
He also said that blood donation could improve the overall cardiovascular health.
According to him, donating blood regularly helps the males in particular to reduce the amount of iron in their blood, which reduces the chances of a heart attack by 88 per cent.
The high level of iron in the blood raises the chance of heart disease, but a regular donation can reduce the risk of severe cardiovascular veins, such as stroke, by 33 per cent.
He said regular blood donation could improve fitness, explaining that donating one pint of blood (450 ml) takes out 650 calories from the donor’s body.
“Blood donation also enhances the production of new blood cells. When blood is withdrawn, the donor’s body immediately begins to replenish the lost blood within 24 hours of donation”, he said.
“All the red blood cells the donor loses during donation are completely replaced within one month or two”.
Regular blood donation, the expert added, could also afford the donor an opportunity to a free health screening and to saving lives. By donating blood, many lives are saved and hope is given to many whose situation might otherwise be hopeless.
Encouraging people to invest in blood donation, he said: “Blood donation brings joy to many; you impact not only the patient whose life may depend on your donation but also all those who depend on that patient,” he said.
On why blood is needed in the blood banks, he explained that it is for emergency purposes such as obstetric, medical, paediatric, neonatal and mass casualty emergencies.
The misconception surrounding blood donation has contributed to why the country is yet to achieve 100 per cent voluntary blood donations and has also fuelled commercialization of blood and blood products in the country.
To a former Chief Blood Recruitment Officer and Haematologist at LUTH, Mr. Anthony Ajayi, safe blood saves lives and improves health.
A professor of obstetrics and gynaecology, Dr. Oluwarotimi Ireti Akinola, echoed similar view when he said that establishing a blood banking system is crucial to reducing maternal deaths caused by haemorrhage.